Active NPI
Quenten Merlin Haack, PT
- Physical Therapist
- Manitowoc, WI
National Provider Identifier
1184458218
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 16912
- Practice address
- 1111 Bayshore Dr
Manitowoc, WI 54220-5548 - Phone
- (920) 794-5166
- NPI assigned
- Aug 30, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 16912 | WI | Primary |
Addresses
Primary practice location
1111 Bayshore Dr
Manitowoc, WI 54220-5548
Mailing address
PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | qhaack337459@direct.myadvocateaurora.org | Direct | |
| FHIR URL | https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16912 | WI | MD | Ophthalmology Physician |
Interoperability endpoints
- qhaack337459@direct.myadvocateaurora.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1724976000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726185600000",
"number": "1184458218",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 735044",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606735044",
"telephone_number": "800-326-2250"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1111 BAYSHORE DR",
"city": "MANITOWOC",
"state": "WI",
"postal_code": "542205548",
"telephone_number": "920-794-5166"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAACK",
"first_name": "QUENTEN",
"middle_name": "MERLIN",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-08-30",
"last_updated": "2024-09-13",
"certification_date": "2024-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "16912",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "qhaack337459@direct.myadvocateaurora.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "1111 Bayshore Dr",
"city": "Manitowoc",
"state": "WI",
"country_code": "US",
"postal_code": "542205548",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "1111 Bayshore Dr",
"city": "Manitowoc",
"state": "WI",
"country_code": "US",
"postal_code": "542205548",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Manitowoc, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.